1. No smoking and quitting smoking.
The World Health Organization’s “Framework Convention on Tobacco Control” requires governments worldwide to jointly adopt comprehensive measures such as legislation, economics, and public education to control tobacco use. Therefore, we need to carry out health education on the harm of smoking and the importance of quitting smoking for cancer prevention in a organized and planned manner among the general public. Include content on the hazards of smoking in school courses from an early age.
- Medical personnel, teachers, cultural and sports workers, journalists, and others should set examples by not smoking.
- Health departments, education departments, news organizations, and mass organizations should conduct publicity and education on the harm of smoking.
- Implement measures to prohibit smoking in all public places. Whether you have been smoking for years, whether you have lung cancer, or how old you are, quit smoking immediately for your own benefit. Quitting smoking will gradually reduce the carcinogenic toxins accumulated in your body. If you are a lung cancer patient, quitting smoking can consolidate your treatment efficacy. Quitting smoking helps restore your immune function, increase your strength, and prevent cancer and other diseases.
2.Preventing occupational lung cancer.
- Government agencies should supervise and manage industrial and mining enterprises.
- Reform production processes, reduce dust and smoke, and lower the concentration of harmful substances in the environment, continuously improving the degree of automation, mechanization, and closed production. Producers should avoid or reduce direct contact with known carcinogens.
- Strengthen personal protection, pay attention to regular operations during production, change work clothes after production, take a shower, and do not take work clothes home.
- Regularly monitor the concentration of harmful substances in the environment and ensure that it does not exceed the national allowable standard, taking effective protective measures in a timely manner.
- Conduct regular physical examinations. If occupational related premalignant lesions or early cancer are found, they should be treated in a timely manner and be transferred from the occupational environment with carcinogenic factors.
3.Prevent environmental pollution.
Countries around the world should establish relevant laws and regulations on air pollution. In 1991, China promulgated the “Details of the Implementation of Air Pollution Prevention and Control Measures”, which played a significant role in preventing lung cancer and other related diseases. The main contents are:
- Governments, industrial and mining enterprises, and construction projects should incorporate air pollution prevention into production and construction plans, and strengthen supervision and management.
- According to the regulations and practices of air pollution prevention and control, construction projects can only be put into production or use after passing the acceptance inspection.
- Prevent dust pollution.
- New residential areas should implement combined heat and power supply or centralized heating, promote low-pollution combustion technology, and gradually limit the combustion of loose coal. The construction of new projects that emit toxic gas and dust in residential areas is prohibited, and those that have been put into production should be purified.
- In special cases, where it is necessary to burn asphalt, oilcloth, rubber, plastic, leather, and other substances that produce toxic and harmful gases in concentrated population areas, the local environmental protection department’s approval is required, and a centralized incineration plant shall be set up for centralized incineration. When melting asphalt during construction and using a fixed melting device, a closed method should be adopted.
- The environmental protection department shall uniformly supervise and manage the prevention of exhaust pollution from motor vehicles and ships. Vehicles that exceed the national standard for pollution emissions shall not be manufactured, sold, or imported, and those who violate national regulations shall be pursued for legal responsibility.
- Keep indoor ventilation constant to avoid indoor air pollution, do not smoke, and reduce kitchen air pollution caused by coal smoke and cooking oil fumes.
4.Dietary prevention and chemical prevention.
American researcher Marchand confirmed that eating more various green leafy vegetables and tomatoes has a significant protective effect against lung cancer. Researchers have observed that lutein in vegetables, lycopene, indole, and other vegetable components have anti-cancer effects on the human body. Ziegler et al. found that cruciferous vegetables (such as canola, cauliflower, cabbage, Chinese cabbage, kale, broccoli, and turnip) have a very prominent protective effect against lung cancer. In addition to the same results as above, the American Cancer Research Institute and the Chinese Academy of Medical Sciences found that allium vegetables (such as garlic and onion) have a protective effect against lung cancer, and their active ingredients may be carotenoids and their complexes.
Vitamin A can maintain the integrity of cell membranes, normal metabolism of epithelial tissue, block cell carcinogenesis, accelerate nuclear DNA repair, and regulate gene expression. Graham found in a Hawaiian multi-ethnic population study that those who intake less than 25,000 international units of vitamin A per month have a higher risk of developing squamous cell lung cancer than those who intake more than 150,000 international units per month.
Derivatives of vitamin A, carotenoids, and xanthophylls have attracted more attention for preventing lung cancer. In 1989, the Hunan Provincial Cancer Hospital reported that two mines in Hunan applied RI (a vitamin A derivative) and vitamin A acid (a derivative of vitamin A) to treat patients with moderately or severely atypical hyperplasia of sputum cells in 1984. After treatment, the general condition improved, and the levels of immunoglobulins IgA and IgM in the blood increased. The lung cancer incidence rate in the treatment group was 1 to 4 compared to the control group, and the average degree of hyperplasia cells decreased, indicating that the product has a certain efficacy in chemical prevention.
The above prevention methods belong to primary prevention.
5.Early detection of cancer increases cure rates and reduces mortality.
This is the secondary prevention of lung cancer. The cure rate for early-stage lung cancer is high, but currently, only less than 20% of lung cancer patients who come to the hospital are in the early and relatively early stages (Stage 1 and 2). The remaining 80% are in the middle and late stages (Stage 3 and 4), which affects the treatment outcome. To increase the number of early-stage patients and improve the cure rate, we should:
- Attach importance to the scientific popularization of lung cancer knowledge, and seek medical treatment promptly if there are pulmonary symptoms.
- Conduct initial screening for lung cancer, targeting high-risk populations, which include: those aged 40 and above, with a severe smoking history (smoking more than 20 cigarettes a day); those with a history of occupational exposure to toxic and harmful substances; those with a family history of cancer; and those with chronic respiratory disease symptoms (such as chronic cough, phlegm, and hemoptysis). Screening methods include chest X-ray indirect fluorescence photography or chest frontal and lateral X-ray films, with additional local tomography or CT scans, sputum cytology tests, and fiberoptic bronchoscopy when necessary.
Sometimes lung cancer cells are found in sputum, but X-ray photography cannot detect the location of cancer due to the tumor being too small, which is known as occult lung cancer. Sometimes the tumor can be detected half a year to a year before X-ray photography shows it. In the past, annual chest X-ray examinations were performed for men and women aged 40 and above, with additional sputum cytology tests for high-risk populations, but the mortality rate did not decrease. Now, screening is conducted every 4 to 6 months, which may improve the detection rate of early-stage lung cancer.
A mining company screened lung cancer in veteran miners (with a mining career of 10 years or more) for over 20 years. The screening methods included chest X-ray frontal and lateral films and sputum cytology tests. When lesions were detected, further diagnosis was performed. The screening discovered a large number of early-stage lung cancers, thus increasing the survival rate after treatment.
We hope to further advance the prevention of lung cancer by vigorously controlling smoking, protecting the environment, detecting precancerous lesions of lung cancer, and discovering and treating high-risk lung cancer patients through molecular biological indicators and gene screening.